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      Frequently Asked Questions About Celiac Disease   04/24/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What is Celiac Disease and the Gluten-Free Diet? What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    FROM POSITANO TO ROME: ONE COUPLE'S QUEST FOR A GLUTEN-FREE HOLIDAY IN ITALY (PART THREE)


    Jill Schaefer

    Celiac.com 11/19/2008 - Day Four: After a ride on a local public bus, which hugged the narrow road's teetering edge and rounded hairpin curves with an alarming sense of speed, we felt grateful for the solid earth beneath our feet in Positano. Our first order of business was to check into the Hotel Villa Rosa and find a nearby trattoria to fill our grumbling stomachs! One of the staff, Stefania, recommended Caffè Positano on the Fornillo side of the town and arranged for a courtesy taxi to deposit us at its doorstep. Without a doubt, its chief allure was the alfresco terrace facing the sea. Situated across the road from the main restaurant and kitchen, the terrace held a dozen or so umbrella-topped tables and beckoned foreigners with unforgettable views.


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    Jill: We decided to share an enormous plate of salty prosciutto and cold sweet melon as an appetizer. Jeff ordered pesce spada griglia (grilled swordfish) and I chose petto di pollo aceto (grilled chicken with a balsamic vinaigrette, parmesan and arugula). We nibbled at each other's dishes and savored every bite of that culinary welcoming, so much so that we'd find ourselves back for more during our stay. Days later, upon seeing zuppa di verdura (minestrone soup) on the menu, Jeff asked how it was prepared. Our server confirmed it did not contain any noodles/macaroni or gluten, and Jeff was pleased to have his fill of the strictly vegetable-based soup, which we learned is how minestrone is typically prepared in the region. Experimental cook that he is, Jeff was eager already to replicate the recipe when we returned home to San Francisco.

    Jeff: The Villa Rosa provided an ample gluten-free breakfast. Each morning my tray included a gluten-free chocolate croissant and gluten-free toast with butter and jam, along with our usual assortment of coffee, tea and yogurt. After we finished a late breakfast, lounging at the beach was one of our favorite things to do. Like many beach areas, lunch fare leaned toward sandwiches, pizzas and the like. The few restaurants tended to be overpriced, but we found a reliable alternative in the salumeria, the Italian version of the delicatessen which means "cured meat shop." It had a variety of cheeses, meats and salads priced by the kilo. In addition to fresh pasta and pasta salads, the place usually had salads that were pasta-free and gluten-free.   

    Also, once I discovered that French fries were readily accessible (yes, in Italy) and the minestrone was, in my experience, always gluten-free, I knew I had a reliable fallback. This reinforced my confidence and led us to make an exception of avoiding sit-down lunches near the beach. We tried La Cambusa, where the waiter called us by our city of origin: Mr. and Mrs. San Francisco.  I had my staple fallback meal, and Jill snacked on a tasty ham and cheese omelet that she washed down with a glass of prosecco.

    Jill: While most of our experiences were positive, we had a few missteps along the way. During our first evening at a beach snack shop, Jeff ordered saltimbocca, a dish generally prepared with rolled veal, prosciutto or ham and cooked in a wine and butter sauce. However, what he ended up with was a sandwich version, pressed between thick slabs of bread, that I stuck in our fridge for my lunch the following day. Another time for dinner, we visited Donna Rosa, a family-run trattoria perched high in the hills of nearby Montepertuso, where the locals know to go to eat well and on the cheap. For an appetizer we chose scallops which, to our consternation, were lightly dusted with a bread-crumb gratin that wasn't described on the menu. These surprises could have been averted, though, if we hadn't let down our guard and relied too heavily on the menu. Ultimately, these experiences nudged us to remember to ask questions upfront and not get too comfortable.

    Day Nine: When we arrived in the more isolated fishing village of Praiano, a veritable country cousin to cosmopolite Positano, Jeff plopped down in the pastel-hued restaurant of the Hotel Margherita mere minutes after dropping his bags. He was famished and awaited a sumptuous plate of spaghetti posillipo, made with the hotel's gluten-free spaghetti and mushrooms. In fact, Jeff was so enamored with the heaping dish of gluten-free goodness that he borrowed my digital camera to snap a photo and in a flurry of excitement accidentally erased all of our other pictures! Well, at least we've got the memories...

    The Hotel Margherita proprietor Suela and her husband Andrea were also attentive to Jeff's breakfast needs. In addition to the standard buffet that had a generous gluten-free assortment of eggs, deli meat, cheeses, yogurt, coffee and tea, they purchased extras for Jeff, including a sweet, gluten-free lemon muffin and gluten-free toast.

    Jeff: On the Vettica side of Praiano, the Trattoria San Gennaro was a brisk fifteen-minute walk from the hotel and sat above the main piazza and church. The view from the terrace was both panoramic and quaint, with the Mediterranean offsetting glittering Positano at night and the piazza coming alive with families sitting about while their children played soccer. The place had been recommended by a kind gentleman named Nicola who works at the Villa Rosa in Positano and lives in Praiano. The restaurant served the best bowl of gluten-free minestrone yet! It was so big I have described it as a “tankard” of soup, loaded with fresh vegetables. Though, you do need to ask the kitchen to hold off on the freshly toasted bread garnish. I’ve rarely been so completely well- fed as when I ordered the fries, minestrone and local fish specialty for dinner on our first night. We lingered well into the night, sipping the local wine and taking in the smell of the sea.

    Day Twelve: Perched on the cliffs, Ravello is often heralded for its gardens, Villa Rufulo and Villa Cimbrone, and has played host to departing Crusaders, famous authors and numerous other visitors throughout history. The town's stone walls, quaint walkways and tight, cobblestone streets exude the charm of antiquity. Gluten-free dining proved to be equally simple here. We arrived at the Hotel Graal early afternoon and were starving after two long cramped bus rides from Praiano. We headed to the restaurant, where the maître d' guided us to a shaded table on the terrace. Soon we lunched on gluten-free mushroom penne pasta and salad and took in stunning views of the ocean and the nearby seaside village of Minori.

    Jill: Perusing our guidebook, we found a trattoria tucked away beyond the main piazza called Cumpa' Cosimo and decided to give it a try for dinner. Thankfully we'd made a reservation, as the medieval-inspired place that was dotted with pictures of celebrities and run by Italian nonna (grandmother) Netta Bottone filled up fast. Everything on the menu looked enticing. The roasted rabbit caught Jeff's eye, along with more minestrone soup. He couldn't seem to get enough of the stuff! Craving comfort food, I bypassed the local specialties for a four-cheese pizza and glass of beer. After trying a bit of Jeff's entrée, though, I had a serious case of rabbit envy! We were pushing our last-bite limits when Netta paraded over to our table with a complimentary dessert, something like a cross between cheesecake and tiramisù, which Jeff picked at in order to avoid the crust (Celiac.com does not recommend doing this), and I couldn't resist polishing off. When Jeff mentioned that he was a writer as we paid our tab, Netta darted back to the kitchen and returned with a plate of figs and grapes. From her garden, she said, and insisted we put them in our pockets for later.

    Day Fourteen: Rome may be the Eternal City, but we had all of a day and a half there to explore, with the half starting after our nine-hour transit by private car, Amtrak train and then a female Formula One taxi driver at Termini Station. Since the next day was Sunday and we had no desire to fight the faithful who would attend mass, we opted for a quick visit to St. Peter's and from there trotted over to the Trastevere district for dinner. The Trastevere, a bohemian counterpart to New York's East Village, is one of my favorite places and it won over Jill, who hadn't quite been captured by the Roman magic.

    Even in August when the area was thick with tourists, street vendors and buskers, it seemed like a breath of fresh air in a city that can be every bit as overbearing as New York or London. We eyeballed a few menus and sniffed out a crowded place that seemed to move food at a good clip. It was elbow-to-elbow seating at our cramped alleyway table, with throngs of tourists shuffling past, but soon we dined under a blue Roman sky at dusk. We enjoyed a flavorful gluten-free meal of fresh salads, veal marsala, mushroom risotto and handmade local sausages. Despite being stuffed already, we couldn't resist some stracciatella (chocolate chip) and nocciola (hazelnut) gelato near the Piazza Santa Maria, where a polished quartet of young classical musicians serenaded the crowd.

    In general, we noticed an abundance of gluten-free salads, soups, roasted meats and risottos in Rome and in all four towns we passed through along the Amalfi Coast. We found reliable delis and easy access to fresh fruit. When we asked, places that did not have gluten-free pasta showed a willingness to prepare any that you provided. So, with a quick trip to the local pharmacy for some gluten-free pasta, you could dine with confidence! Contrary to our fears before the trip, eating gluten-free while traveling in Italy proved easy to do. With a bit of planning, a call to the airline to line up a gluten-free meal, an Italian/English explanation of your dietary needs and the standard caution nearly all people with gluten intolerance bring to eating out, anyone can look forward to an enjoyable, gluten-free holiday in Italy.

    Co-written by Jefferson Adams


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    Guest Phyllis Morrow

    Posted

    Though I cringed at the idea of picking around the crust of the tiramisu (aren't you concerned about cross-contamination?) I enjoyed your article and am looking forward to a gluten-free trip to Italy next fall. I've been told that bakeries usually offer good gluten-free bread, too. What's your experience there?

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    Guest Elizabeth Cella

    Posted

    Brava, Jill! We had a similar experience in Italy with our gluten-free daughter. Italy also has a high incidence of celiac disease, and Italian children are routinely screened for it. We found that Italians routinely were aware of dining gluten-free, and were happily accommodated. Gluten-free pastas and foods are available in refrigerated cases in most pharmacies, marked by a green cross.

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    It does not sound like Jeff is strictly gluten-free if he can order something without realizing that it is a breaded sandwich. I am very sensitive to ingredients such as gluten and dairy and ask about ingredients and about how things are cooked. If language is a problem (if I cannot communicate clearly with the staff), which is especially possible when traveling abroad, I cannot eat at the restaurant.

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    Guest Tracy

    Posted

    Many thanks for this encouraging travel report! I've just been diagnosed and am adjusting to living gluten-free. I live in the Bay Area and notice that you are from San Francisco. I hope you will write more about your local dining experiences. I have not discovered a good source of gluten free restaurant recommendations yet.

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    Guest Kati

    Posted

    Thank you for a wonderful article that calms many of my fears of traveling, having just gone gluten-free recently (and so far it seems to have helped ease much of the digestive uncomfortable-ness that I've lived with for most of my life!) I already feel limited by food at home, let alone abroad! Italy is my dream trip and I didn't know if the land of pasta and bread would be possible. THANK YOU for the wonderful tips, especially specific restaurants and hotels that catered to your gluten-free needs! Is there any possibility of posting your English/Italian request that you sent the hotels about your special dietary needs? This could be helpful to many - in America and abroad!

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    Guest Jennifer

    Posted

    I am so happy that I stumbled upon this article. My family and I have traveled to Italy routinely over the last decade, but my husband has just been diagnosed with Celiac disease in the last couple of weeks. One of our first thoughts was how we would fare when we went back to Italy, and now I feel much better about our ability to enjoy the authentic cuisine without too much hassle. Thank you so much for the time and effort in recording your travels and experiences in Italy.

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    I'm curious to know, when you ordered french fries or gluten

    free pasta at these restaurants, how did you know if they prepared them in oil or water that wasn't contaminated with

    gluten from other foods?

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    Guest Deborah

    Posted

    My husband and I learned we both had the celiac gene just a week before our trip to Italy. But, like you, we had no trouble whatsoever with the food. As a matter of fact, we loaded our suitcase with gluten-free pastas and "toasts" we purchased there. (Unfortunately, we can't find the same brands in the States.) We didn't think to actually request gluten-free at the restaurants, but were delighted with all the dishes we found on our own that met our dietary requirements. We were in the Amalfi area (Maiori, Ravello, etc.), Rome and Orvieto and not once did we go hungry or have to violate our dietary restrictions.

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    Guest Robert

    Posted

    Thank you for such a wonderful article. We are planning a trip to the Amalfi coast next year and this made us a little less apprehensive about eating out. My wife is not celiac, but is gluten sensitive and will have terrible cramping and fever like symptoms for a day or two if she eats gluten. She can relate with your husband eating the cheesecake around the crust. She did the same thing with a similar cake in Chicago, because it was too good to pass up and she was willing to take the chance. Hope to read more. Thank you!

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    Jill Schaefer
    Celiac.com 08/07/2008 - We'd begun practicing basic Italian⎯buon giorno! We'd practically memorized the Frommer's travel guide. We'd scoured multitudes of online travel sites and finally made all the arrangements for our once-in-a-lifetime romantic getaway to the sun-kissed shores of the Amalfi Coast.
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    http://healthlink.mcw.edu/article/1009402816.html http://celiac-disease.emedtv.com/celiac-disease/ celiac-disease-screening.html http://www.prlog.org/10063446-at-last-the-gluten-free-guide-to-italy-guide-to-the-gluten-free-land-of-pasta.html http://www.celiachia.it/default.asp
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    Celiac.com 09/11/2008 - After a two-leg flight and multiple trains, Jeff and I finally stepped off the local Circumvesuviana train in sunny Sorrento, our first destination on the fabled Amalfi Coast. It was hot, or as the Italians say, molto caldo. We’d been traveling for nearly 24 hours straight, and as we lugged our bags along the final stretch of cobbled sidewalks toward Casa Astarita, we both felt exhausted, ravenous and more than a bit disoriented.
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    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
    That’s where the story takes a dangerous turn….about 3:15am. I awoke to the TV blaring loudly, along with the lights shining brightly. Our power was back on! I proceeded to walk throughout the house turning everything off at exactly the same time our neighbor, who was told to evacuate our street, saw me through our window, assuming I knew that our hillside was ablaze with flames. Flames that were shooting 50 feet into the air. I went back to bed and fell fast asleep. The fire department was assured we had left because our house was dark and quiet again. Two hours had passed.  I suddenly awoke to screams coming from a family member yelling, “fire, fire, fire”! Flames were shooting straight up into the sky, just blocks from our house. We lived on a private drive with only one way in and one way out.  The entrance to our street was full of smoke and the fire fighters were doing their best to save our neighbors homes. We literally had enough time to grab our dogs, pile into the car, and speed to safety. As we were coming down our street, fire trucks passed us with sirens blaring, and I wondered if I would ever see my house and our possessions ever again. Where do we go? Who do we turn to? Are shelters a safe option? 
    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
    After being scoped at Children's Hospital of Chicago, and my daughters Celiac Disease officially confirmed, I worried about her getting all the nutrients her under nourished body so desperately needed. I already knew she had a peanut allergy from blood tests, but just assumed she would be safe with other nuts. I was so horribly wrong. After feeding her a small bite of a pistachio, which she immediately spit out, nuts would become her enemy. Her anaphylactic reaction came within minutes of taking a bite of that pistachio. She was complaining of horrible stomach cramps when the vomiting set in. She then went limp and starting welting. We called 911.
    Now we never leave home without our Epipens and our gluten free food supplies. We analyze every food label. We are hyper vigilant about cross contamination. We are constantly looking for welts and praying for no stomach pain. We are always prepared and on guard. It's just what we do now. Anything to protect our child, our love...like so many other parents out there have to do every moment of ever day!  
    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.